Abstract: The cardiotoxicity associated with anti-cancer agents limits the clinical practice of cancer therapies. Asides traditional treatments such as chemotherapy and radiotherapy, new innovations in cancer treatments such as targeted therapy and immunotherapy are associated with different frequency and degrees of cardiotoxicity, which may result in heart failure and death. The mechanism underlying cancer therapy induced cardiotoxicity is still unclear. Oxidative stress, DNA damage, and apoptosis may be responsible for the differences in the cardiotoxicities of various cancer therapies. MicroRNAs (miRNAs) are key regulators of cell proliferation, cell death, and cell differentiation. MicroRNAs are also associated with cardiac remodeling and cardiotoxicity and play an important role in the development of a variety of cardiovascular diseases. This review will focus on the mechanisms by which different cancer therapies induce cardiotoxicity, especially those that involve miRNAs and the evaluation of miRNA in the monitoring and treatment of cancer therapy related cardiotoxicity.